﻿CREATE TABLE [dbo].[CLM_837I_2400_ClaimLineItems]
(
[ServiceLine_LX01_AssignedNumber] [nvarchar] (6) COLLATE SQL_Latin1_General_CP1_CI_AS NULL,
[InsServiceLine_SV201_ServiceLineRevenueCode] [nvarchar] (48) COLLATE SQL_Latin1_General_CP1_CI_AS NULL,
[InsServiceLine_SV202_ProductOrServiceIDQualifier] [nvarchar] (2) COLLATE SQL_Latin1_General_CP1_CI_AS NULL,
[InsServiceLine_SV202_ProcedureCode] [nvarchar] (50) COLLATE SQL_Latin1_General_CP1_CI_AS NULL,
[InsServiceLine_SV202_ProcedureModifier1] [nvarchar] (2) COLLATE SQL_Latin1_General_CP1_CI_AS NULL,
[InsServiceLine_SV202_ProcedureModifier2] [nvarchar] (2) COLLATE SQL_Latin1_General_CP1_CI_AS NULL,
[InsServiceLine_SV202_ProcedureModifier3] [nvarchar] (2) COLLATE SQL_Latin1_General_CP1_CI_AS NULL,
[InsServiceLine_SV202_ProcedureModifier4] [nvarchar] (2) COLLATE SQL_Latin1_General_CP1_CI_AS NULL,
[InsServiceLine_SV203_LineItemChargeAmount] [money] NULL,
[InsServiceLine_SV204_UnitOrBasisForMeasurementCode] [nvarchar] (2) COLLATE SQL_Latin1_General_CP1_CI_AS NULL,
[InsServiceLine_SV205_ServiceUnitCount] [int] NULL,
[InsServiceLine_SV206_ServiceLineRate] [nchar] (10) COLLATE SQL_Latin1_General_CP1_CI_AS NULL,
[InsServiceLine_SV207_LineItemDeniedChargeOrNonCoveredChargeAmount] [money] NULL,
[ServiceLineDate_DTP03_ServiceDate] [nvarchar] (35) COLLATE SQL_Latin1_General_CP1_CI_AS NULL,
[AssessmentDate_DTP03_AssessmentDate] [nvarchar] (35) COLLATE SQL_Latin1_General_CP1_CI_AS NULL,
[ServiceTaxAmt_AMT02_ServiceTaxAmount] [nvarchar] (18) COLLATE SQL_Latin1_General_CP1_CI_AS NULL,
[FacilityTaxAmt_AMT02_FacilityTaxAmount] [nvarchar] (18) COLLATE SQL_Latin1_General_CP1_CI_AS NULL,
[LinePricing_HCP01_PricingMethodology] [nvarchar] (2) COLLATE SQL_Latin1_General_CP1_CI_AS NULL,
[LinePricing_HCP02_RepricedAllowedAmount] [nvarchar] (18) COLLATE SQL_Latin1_General_CP1_CI_AS NULL,
[LinePricing_HCP03_RepricedSavingAmount] [nvarchar] (18) COLLATE SQL_Latin1_General_CP1_CI_AS NULL,
[LinePricing_HCP04_RepricedOrganizationalIdentifier] [nvarchar] (30) COLLATE SQL_Latin1_General_CP1_CI_AS NULL,
[LinePricing_HCP05_RepricingPerDiemFlatRateAmount] [nvarchar] (9) COLLATE SQL_Latin1_General_CP1_CI_AS NULL,
[LinePricing_HCP06_RepricedApprovedAmbPatientGrpCode] [nvarchar] (30) COLLATE SQL_Latin1_General_CP1_CI_AS NULL,
[LinePricing_HCP07_RepricedApprovedAmbPatientGrpAmount] [nvarchar] (18) COLLATE SQL_Latin1_General_CP1_CI_AS NULL,
[LinePricing_HCP08_RepricedApprovedRevenueCode] [nvarchar] (48) COLLATE SQL_Latin1_General_CP1_CI_AS NULL,
[LinePricing_HCP09_ProductOrServiceIDQualifier] [nvarchar] (2) COLLATE SQL_Latin1_General_CP1_CI_AS NULL,
[LinePricing_HCP10_RepricedApprovedProcedureCode] [nvarchar] (48) COLLATE SQL_Latin1_General_CP1_CI_AS NULL,
[LinePricing_HCP11_UnitOrBasisForMeasurementCode] [nvarchar] (2) COLLATE SQL_Latin1_General_CP1_CI_AS NULL,
[LinePricing_HCP12_RepricedApprovedServiceUnitCount] [nvarchar](15) COLLATE SQL_Latin1_General_CP1_CI_AS NULL,
[LinePricing_HCP13_RejectReasonCode] [nvarchar](2) COLLATE SQL_Latin1_General_CP1_CI_AS NULL,
[LinePricing_HCP14_PolicyComplianceCode] [nvarchar](2) COLLATE SQL_Latin1_General_CP1_CI_AS NULL,
[LinePricing_HCP15_ExceptionCode] [nvarchar](2) COLLATE SQL_Latin1_General_CP1_CI_AS NULL,
[AttendingPhysician_NM102_EntityTypeQualifier] [nvarchar] (1) COLLATE SQL_Latin1_General_CP1_CI_AS NULL,
[AttendingPhysician_NM103_LastName] [nvarchar] (35) COLLATE SQL_Latin1_General_CP1_CI_AS NULL,
[AttendingPhysician_NM104_FirstName] [nvarchar] (25) COLLATE SQL_Latin1_General_CP1_CI_AS NULL,
[AttendingPhysician_NM105_MiddleName] [nvarchar] (25) COLLATE SQL_Latin1_General_CP1_CI_AS NULL,
[AttendingPhysician_NM107_Suffix] [nvarchar] (10) COLLATE SQL_Latin1_General_CP1_CI_AS NULL,
[AttendingPhysician_NM108_IdentificationCodeQualifier] [nvarchar] (2) COLLATE SQL_Latin1_General_CP1_CI_AS NULL,
[AttendingPhysician_NM109_PrimaryIdentifier] [nvarchar] (80) COLLATE SQL_Latin1_General_CP1_CI_AS NULL,
[AttendingPhysician_REF01_ReferenceIDQualifier] [nvarchar] (3) COLLATE SQL_Latin1_General_CP1_CI_AS NULL,
[AttendingPhysician_REF02_SecondaryIdentifier] [nvarchar] (30) COLLATE SQL_Latin1_General_CP1_CI_AS NULL,
[OperatingPhysician_NM103_LastName] [nvarchar] (35) COLLATE SQL_Latin1_General_CP1_CI_AS NULL,
[OperatingPhysician_NM104_FirstName] [nvarchar] (25) COLLATE SQL_Latin1_General_CP1_CI_AS NULL,
[OperatingPhysician_NM105_MiddleName] [nvarchar] (25) COLLATE SQL_Latin1_General_CP1_CI_AS NULL,
[OperatingPhysician_NM107_Suffix] [nvarchar] (10) COLLATE SQL_Latin1_General_CP1_CI_AS NULL,
[OperatingPhysician_NM108_IdentificationCodeQualifier] [nvarchar] (2) COLLATE SQL_Latin1_General_CP1_CI_AS NULL,
[OperatingPhysician_NM109_PrimaryIdentifier] [nvarchar] (80) COLLATE SQL_Latin1_General_CP1_CI_AS NULL,
[OperatingPhysician_REF01_ReferenceIDQualifier] [nvarchar] (3) COLLATE SQL_Latin1_General_CP1_CI_AS NULL,
[OperatingPhysician_REF02_SecondaryIdentifier] [nvarchar] (30) COLLATE SQL_Latin1_General_CP1_CI_AS NULL,
[OtherProvider_NM102_EntityTypeQualifier] [nvarchar] (1) COLLATE SQL_Latin1_General_CP1_CI_AS NULL,
[OtherProvider_NM103_LastName] [nvarchar] (35) COLLATE SQL_Latin1_General_CP1_CI_AS NULL,
[OtherProvider_NM104_FirstName] [nvarchar] (25) COLLATE SQL_Latin1_General_CP1_CI_AS NULL,
[OtherProvider_NM105_MiddleName] [nvarchar] (25) COLLATE SQL_Latin1_General_CP1_CI_AS NULL,
[OtherProvider_NM107_Suffix] [nvarchar] (10) COLLATE SQL_Latin1_General_CP1_CI_AS NULL,
[OtherProvider_NM108_IdentificationCodeQualifier] [nvarchar] (2) COLLATE SQL_Latin1_General_CP1_CI_AS NULL,
[OtherProvider_NM109_PrimaryIdentifier] [nvarchar] (80) COLLATE SQL_Latin1_General_CP1_CI_AS NULL,
[OtherProvider_REF01_ReferenceIDQualifier] [nvarchar] (3) COLLATE SQL_Latin1_General_CP1_CI_AS NULL,
[OtherProvider_REF02_SecondaryIdentifier] [nvarchar] (30) COLLATE SQL_Latin1_General_CP1_CI_AS NULL,
[ServiceLineAdjudication_SVD01_PayerIdentifier] [nvarchar] (80) COLLATE SQL_Latin1_General_CP1_CI_AS NULL,
[ServiceLineAdjudication_SVD02_ServiceLinePaidAmount] [nvarchar] (18) COLLATE SQL_Latin1_General_CP1_CI_AS NULL,
[ServiceLineAdjudication_SVD0301_ServiceIDQualifier] [nvarchar] (2) COLLATE SQL_Latin1_General_CP1_CI_AS NULL,
[ServiceLineAdjudication_SVD0302_ProcedureCode] [nvarchar] (48) COLLATE SQL_Latin1_General_CP1_CI_AS NULL,
[ServiceLineAdjudication_SVD0303_ProcedureModifier] [nvarchar] (2) COLLATE SQL_Latin1_General_CP1_CI_AS NULL,
[ServiceLineAdjudication_SVD0304_ProcedureModifier] [nvarchar] (2) COLLATE SQL_Latin1_General_CP1_CI_AS NULL,
[ServiceLineAdjudication_SVD0305_ProcedureModifier] [nvarchar] (2) COLLATE SQL_Latin1_General_CP1_CI_AS NULL,
[ServiceLineAdjudication_SVD0306_ProcedureModifier] [nvarchar] (2) COLLATE SQL_Latin1_General_CP1_CI_AS NULL,
[ServiceLineAdjudication_SVD0307_ProcedureCodeDescription] [nvarchar] (80) COLLATE SQL_Latin1_General_CP1_CI_AS NULL,
[ServiceLineAdjudication_SVD04_ServiceLineRevenueCode] [nvarchar] (48) COLLATE SQL_Latin1_General_CP1_CI_AS NULL,
[ServiceLineAdjudication_SVD05_PaidUnitsOfService] [nvarchar] (15) COLLATE SQL_Latin1_General_CP1_CI_AS NULL,
[ServiceLineAdjudication_SVD06_BundledUnbundledLineNumber] [nvarchar] (6) COLLATE SQL_Latin1_General_CP1_CI_AS NULL,
[ServiceAdjudicationDate_DTP03_ServiceAdjudicationOrPaymentDate] [nvarchar] (35) COLLATE SQL_Latin1_General_CP1_CI_AS NULL,
[Subscriber_NM109_SubscriberPrimaryIdentifier] [nvarchar] (80) COLLATE SQL_Latin1_General_CP1_CI_AS NULL,
[Claim_CLM01_PatientAccountNumber] [nvarchar] (38) COLLATE SQL_Latin1_General_CP1_CI_AS NULL,
[Subscriber_HL01_SubscriberHierarchicalIDNumber] [nvarchar] (12) COLLATE SQL_Latin1_General_CP1_CI_AS NULL,
[Patient_HL01_PatientHierarchicalIDNumber] [nvarchar] (12) COLLATE SQL_Latin1_General_CP1_CI_AS NULL,
[IDKey] [int] NOT NULL IDENTITY(1, 1),
[BTSMessageID] [nvarchar] (100) COLLATE SQL_Latin1_General_CP1_CI_AS NULL,
[BTSInterchangeID] [nvarchar] (100) COLLATE SQL_Latin1_General_CP1_CI_AS NULL
) ON [PRIMARY]


